Liberty Behavioral Healthcare LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

LIBERTY BEHAVIORAL HEALTHCARE LLC

Practice address

10903 Glenshire Dr
Glenn Dale, MD 20769-9160

Phone

(240) 595-5511

NPI assigned

May 27, 2021

Last updated

Aug 14, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Quinta Manenju, CRNP-PMHNPI 1629323464

Title

Owner

Phone

(240) 595-5511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Quinta Manenju

  • Psychiatric/Mental Health Nurse Practitioner
  • Bowie, MD
  • NPI 1629323464

  DC

  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1366018764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10903 GLENSHIRE DR",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699160",
            "telephone_number": "240-595-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10903 GLENSHIRE DR",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699160",
            "telephone_number": "240-595-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY BEHAVIORAL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "MANENJU",
        "authorized_official_first_name": "QUINTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-595-5511",
        "authorized_official_credential": "CRNP-PMH"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry W. Bryant DDS, PC
• Nicole C Lawson, OT
• Sheila Lebrun-James, RN
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• Cassie Leghu
• Life Pearls Support Services
• Luminis Health Medical Group, LLC
• Ifeyinwa Maduka
• Pauline A Magny
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• Psychiatric/Mental Health Nurse Practitioner in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.